Our guest blogger today is medical school blogger Carly from Doctors of Tomorrow!
Hi everyone! My name is Carly and I am a fourth year medical student at the University of Arkansas for Medical Sciences. I applied for residency in Pediatrics and, along with every other M4, am anxiously awaiting Match Day. Since my pre-med days, I have been blogging about my journey to becoming a physician on my site, Doctors of Tomorrow. When taking a break from medicine, I enjoy traveling, all things Disney (really, what Pediatrician doesn’t?), and spending time with my dog, Koda.
I am nearing graduation, and I wanted to take a look back on these whirlwind four years to give you a timeline of medical school and some perspective of what you can expect in MS1, MS2, MS3, and MS4!
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The Timeline of Medical School
You hold the envelope in your hand. Inside is a piece of paper that will determine what you will be doing for the next four years of your life. You muster up the courage to open it and quickly skim its contents for the one word you have been striving towards: ACCEPTED. Your breath catches in your throat as the first thought that jumps into your head is that this might be a mistake. You read the word again to make sure you saw it correctly. You did. Then, you scan your eyes toward the top of the page to check whether this letter was meant for someone else or if it is your name that is on the top. It is. You have been accepted into medical school. Congratulations!
Now what? What happens next? Do you even really know what happens in medical school? There are so many different aspects of medical school to keep track of – from rotations, to USMLE exams, to ultimately applying for residency. This post will highlight all the major events of medical school and when they all occur. Buckle up, it is quite the journey!
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You take a deep breath and walk into the doors of the auditorium for your first lecture. You are starting medical school. It can take a few days, or even weeks, to get accustomed to this change, not to mention the amount of coursework that you are suddenly responsible for. You will also be starting (gross) anatomy lab shortly after school starts. This is the first time where you really begin to feel like you are becoming a doctor. Soak it in, but also stay focused and learn as much as you can.
You have made it through the first semester. To be honest, you aren’t really sure how, but you did. Take the winter break to unwind, you deserve it. Make time to spend with family and friends, especially some friends outside of med school, people whom you may not have had much time to see in the past 4 months. Read a good book, something that is not a textbook, and enjoy the time off.
While, for some, it may have felt like the year flew by and for others it couldn’t have gone slower, it’s over and summer is here. This will be the only summer that has a good chunk of time where you don’t have to be studying for exams, so make the most of it. Relax as much as possible, travel someplace you’ve always wanted to go, or go on a mission trip. If you already have an idea of what kind of medicine you might like to specialize in, find a physician who does that type of work and shadow them. Volunteer some of your time to a free clinic and practice your history taking and physical exam skills. If you want to go into one of the more competitive specialties, then you might want to use this summer to get ahead and start doing some research and board prep.
School starts again. Time to get back at it and crush this year!
You have been doing your best, learning as much as you can from each course, which is the first layer of Step 1 studying. However, you will be taking the USMLE Step 1 exam in about 5 months, so it is time to starting thinking about how to tackle this mountain. Research study plans and decide what resources you are going to use. Are you going to take a dedicated Step 1 study course or develop your own plan? Are you going to study as a group or by yourself? Evaluate how you study best and develop a course of action that will help you succeed. Also, start looking at Step 1 exam dates and plan when and where you want to take the test. You will need to register for the Step 1 as early as possible if you are want one of the more popular dates, which are typically in the last couple weeks of June. If needed, you can also reschedule your USMLE Step 1 exam date (there is a fee if you try to change it thirty or fewer days before the originally scheduled test date).
Second year is finished, so now it’s time to buckle down and start your dedicated Step 1 study period. Typically, this time ranges from 4-6 weeks and include about 8-12 hours of studying per day. If you have the time, take a few days after finishing the school year to just decompress. Do something fun and spend time with family and friends, then come back refreshed and ready to focus on studying. Since you have already developed your study plan, you don’t have to waste time now deciding on what you are going to do. A lot of the success of Step 1 comes from effective planning. There is a ton of material to go over and remember, so stick to your study plan and chip away at the information bit by bit.
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USMLE Step 1
With all that’s riding on this one exam, there are so many resources out there to help students study for Step 1. So many in fact, that I quickly found myself overwhelmed when trying to decide how I was going to study. Finally, I just had to pick what I thought would work best for me and stick to it. Here are the resources I ended up using:
- First Aid for the USMLE Step 1: During my 5-week dedicated study period, I read through all of First Aid about 1.5 times. For the second pass, I mostly focused on my weak areas.
- UWorld: With over 2000 questions, I probably spent most of my dedicated study time doing UWorld questions. Obviously, you have to know the material, but another huge part of doing well on Step 1 is being able to dissect through the questions. With huge vignette question stems, lab values, and sometimes 10 or more answer choices, this is not an easy task. Doing several blocks of UWorld questions every day was key to learning how to pick out the important information in the questions and get used to managing my time.
- Practice USMLE Step 1 Tests: I took a total of 4 mock tests during my 5 weeks of intensive study. I took the 2 UWorld Self Assessments and 2 NBMEs. These are extremely helpful in knowing where you stand score-wise and what you need to keep working on. To get the most out of these tests, try to simulate the actual test day as much as possible. Bring the same snacks you are planning on bringing on the real test day and time your breaks to what it will be like at the real thing. This way, the actual test day will go much smoother because you know more of what to expect. Anything that helps reduce stress or unexpected surprises is key to being able to put more of your attention and energy on the test itself. I found the UWorld Self Assessments and the NBMEs (at least the two I took) to be very different from each other. I would recommend using both to be able to get a better variety of what to expect on the real thing. Here is also an official sample of Step 1 questions.
- Other Resources: In addition to what’s mentioned above, I used SketchyMicro and Pathoma. I wanted to keep my resources simple to avoid being overwhelmed with so many ways to study. I picked these two because I knew microbiology and pathology were two areas I needed the most help (unfortunately SketchyPharm and SketchyPath were not out yet when I took Step 1). I also loved being able to mix up my study routine with these two video resources instead of having to read another textbook. It helped things stay interesting and kept me on task. I highly recommend them both!
- SketchyPharm and SketchyPath were not yet released when I was studying for Step 1, but I definitely would have loved to use them too if they had been!
- Other Tips:
- Probably the biggest tip I have is to be ok with changing the way you’re studying if you know whatever you’re doing truly isn’t working. The only thing I regret from this experience was basically wasting a whole week of study time, because I didn’t want to admit that what I was doing wasn’t working for me. For the first week of my dedicated study prep, I started out by only reading First Aid and doing UWorld questions. I thought I was doing well because I was getting through First Aid so quickly. I didn’t even realize that I was not retaining the information at all. I took my first NBME at the end of that first week and was brought back to reality with a score that was not what I expected at all. I realized right then that something needed to change. So, I decided to bring out my trusty white board. Throughout first and second year, I used my white board to study, but with so much information, I thought it would take too much time to study this way for Step. I had to accept, though, that this was the only way I was going to be able to retain what I was reading. So, I started reading a section in First Aid then going over to my white board and trying to write down everything I remembered about that section. It really helped me solidify the information and realize what I wasn’t actually understanding. I only wish I had started using this method from the beginning of dedicated study prep.
- “Smart Book”: Basically, a “smart book” is your own personal First Aid. It’s just a notebook where you write down any piece of information that you need to remember. Mine included equations that I kept forgetting, mnemonics, and key points that I needed to know in order to answer a UWorld question correctly. Then, every night, I would read through my smart book. Repetition was key for me! Eventually, I found myself remembering points from my smart book and was able to get more and more questions correct. I definitely recommend using a Smart Book to study for big exams in general, and especially USMLE exams.
Overall, Step 1 was rough but not the impossible feat that I was expecting. The key was dedication, effective study time, and periods of stepping back and taking a few moments for myself. Surviving those 5 weeks would not have been possible without support from friends and family. Sometimes, a good rant session with friends from my class while walking around the outside track was necessary to let out all the built up frustration. Then, I was able to feel much better and get back to the study grind.
Depending on your school and how much time you have dedicated to studying, you will probably be taking Step 1 sometime in June. Take the day before the exam to relax. No studying allowed. At this point, you aren’t going to learn and retain anything that will make a monumental difference on the exam. Trust that you have studied hard and done all that you can. Now, focus on preparing your mind and body for the marathon that will be exam day.
Whew, Step 1 is over! Now, it’s time to start concentrating on your third year clerkships, which will typically start in July. For the most part (at least at most medical schools), your medical classroom education ends after MS2. Most clerkship lectures will be in hospitals, and you will only occasionally go back to campus in MS3 and MS4.
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Around January of your third year, it is important to think ahead and decide when you want to take USMLE Step 2 CS. Students typically take this exam in April-June of their third year or sometimes in July of their fourth year. Because USMLE Step 2 CS is only offered in five exam locations in the whole country, spots fill up super quickly. Schedule this exam several months in advance of when you would like to take it in order to get a spot. If you already know when you’d like to take USMLE Step 2 CK, go ahead and schedule this as well.
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Also, during this time of year, you will probably be scheduling courses and electives for fourth year. Think about what electives you would like to take and whether you are going to do an away rotation and begin applying for these. Remember that October-January of your fourth year will be interview season, so try not to schedule your busier rotations during this time if you can help it.
Take USMLE Step 2 CS. Most likely you will have to travel to a testing location, so be sure to take this into consideration when scheduling when to take the exam. If you didn’t go ahead and schedule Step 2 CK when you scheduled CS, do this now. Spots don’t fill up as quickly as CS since there are many more testing locations, but you might want to make sure to get a certain day that works best for you.
During the end of third year and into the first couple of months of fourth year is when students typically take USMLE Step 2 CK. Plan out 3-4 weeks or longer to study for USMLE Step 2 CK, depending on your rotation schedule and how much time you will have to dedicate to studying.
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In the first couple months of MS4, you will start planning to apply to residency programs. Decide who you would like to write your recommendation letters and ask them early. Mentors are busy and appreciate plenty of heads up to write a recommendation instead of just asking them the week before it’s due. Start writing your personal statement and updating your resume/CV early as well. Then, you will have plenty of time for editing and even asking your mentors to review these before submitting them. Many letter writers also want your CV and personal statement to reference when writing your letter, so having these ready will be important.
Also, go ahead and start researching programs you might want to apply to. Think about what type of program you see yourself thriving in and look up which ones meet these goals. Having at least a rough draft of what programs you will apply to in advance will make submitting your application that much easier and less time consuming.
Early September is when you can officially submit your ERAS application and apply for residency programs. The application will open sometime a few months before, so you can start entering in your information whenever you get a chance. Plus, having your CV and personal statement already finished will make this process much faster.
Although you can submit your ERAS application after the opening day, I would recommend submitting it as early as you can, preferably even the first day it is open. Many residency programs start sending out interview invitations as soon as they start receiving applications. So, if you wait to submit your application, there is a chance that they have already given out all their invites and you won’t even get the opportunity to show them how great you are.
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After submitting your ERAS application, you will start receiving interview invitations from programs. During this time, students are typically checking their emails every few seconds to be able to accept invitations quickly. Keep a calendar close by so you can see what dates you have available and don’t accidentally over book.
Here are my top tips and advice I learned from going through the Match process.
Residency interviews will run from October through January of your fourth year. If possible, try to schedule interviews strategically by location and time in order to save time and money on travel. Being able to travel around and visit so many different programs is fun, but can get pretty exhausting. Do whatever you can to make this process easier for you, so that you can be your best at every interview.
By this time in MS4, you have visited many different programs, met so many different people, and now it is time to decide which ones you liked best and see yourself training at. Sometime in mid to late February, you will submit your NRMP rank list, which basically is a list of programs you would be willing to train at in order of preference. The programs also make a list of the students they would like at their programs, and then the computer algorithm tries to pair up students with programs as best it can.
Match Day! Whether you will just receive an email or your school plans a big reveal party, this is when you will find out exactly what program you matched with and where you will do your residency training.
You have matched into a program and have a job for next year, now it is time to relax and enjoy the rest of fourth year. No more Step exams, applications, interviews, or uncertainty of what will happen after you graduate from medical school. Now is the time to have fun and do the things that you might not have time for in residency. However, be sure to be invested in the rest of your rotations as well. It might be the last chance you will have to learn a lot of this material, especially if it is something outside of your specialty, so make the most of it. During this time, you will also be planning for residency. You will have to sign your contract, fill out paperwork for your program, and plan to move if your program is in a different city.
Graduation! It has been four years since you took a deep breath and walked into those auditorium doors for your first lecture. You have studied more than you ever thought possible, made so many sacrifices, developed friendships that will last forever, and had experiences with patients that you will never forget. Congratulations, you made it! You are a doctor!
After graduation, you will need to get everything ready to start residency. If needed, you will have to move and get established in a new city or even a new state. Make sure to have time to do something fun, because you probably won’t have time for it during residency. You will also have residency orientation at your program a week or two before actually starting.
After Graduation: July 1st
You take a deep breath and walk into the doors of the hospital on your first day of residency. “Good morning, Doctor”, you hear someone say. You think, “Oh, they were talking to me? That’s right, I am a Doctor.” The next adventure of your life starts now!
Feel free to connect with Carly on Facebook, Instagram, and Twitter!
Update: Congratulations to Carly on matching into her first choice residency! Cheers to the next adventure!